Foster and Kin Care

Foster and Kin Care –

Healing the Trauma that Predisposes Youth Offending

Jill Worrall MSW

This paper argues that while New Zealand child welfare law is both culturally sensitive and observing of the key importance of maintaining family/whanau identity and psychological links, traditional welfare and youth justice care systems are not able to address the multiple determinants that lead to both child abuse and offending.

The predisposing factors that lead to anti-social behaviour in young persons are well evidenced in research. Empirical research shows that such behaviour is multi-determined, arising out of the interrelationship of individual characteristics of the young person, family characteristics, peer relationships, poor educational achievement and community characteristics. Family histories of domestic violence, offending, drug abuse, psychiatric illness and child abuse and neglect are cited as being pre-dispositional to anti-social behaviour (Hengeller et al, 1998). Recent New Zealand research of custodial kin carers showed that all these factors, along with parental imprisonment were the reasons for care cited (Worrall 2005, pp 28, 29). The consequent behaviours of the children and young people in their care were significant. Attachment disorders, severe aggressive behaviour, destructive behaviour, conduct disorder, post traumatic stress disorder and attention deficit disorders were described (Worrall, 2005, pp 35, 36). A review of contemporary international foster care research strongly evidences the fact that the increasingly demanding nature of the caring role has given rise to serious consideration of whether foster care can, or even should, continue to be a voluntary undertaking or whether the time has come for it to assume professional status with a prescribed role and educational requirement.

While the literature strongly argues for the institution of professional foster care services and highly trained caregivers who offer specialised services and who are appropriately remunerated and accountable, recent data from Child Youth and Family show a significant trend towards placing children and young people within extended family/whanau (Table 1). The Children Young Persons and their Families Act (1989) clearly states that families must be the first placement option to be considered and that they should be given all assistance to care and make decisions about the preferred outcomes for their young people (s.5, s.13, s.208 CYPF Act). Family continuity policies are now internationally seen as good social work practice, and there is now universal recognition of the role attachment plays in affecting overall optimum development (Mc Fadden & Worrall 1999; Cole, 2006). Relationships play a fundamental role in our psychological development. The critical importance of brain development in relation to the ability of children to form healthy social relationships is well documented. Early trauma can affect the brain’s ability to develop essential connections that are critical for attachment relationships to occur.

Family reunification should always be the primary goal of foster care, and long standing research shows that foster carers can be excellent facilitators of return home. A shift from what the literature has termed exclusive foster care to inclusive foster care, in which the foster parents are expected to include the family of origin in the life of the child as much as possible, and thereby in the life of the foster family is now, internationally expected, but not evidenced in New Zealand. This philosophical shift in the role of carer is intrinsic in the changing definition of foster care from substitute care to supplemental care, the foster parents supplementing the role of the birth family, not replacing it. Colton & Williams argue, however, that while physical reunification runs a great risk of failure, that this may reflect a traditional mindset, as opposed to an inherent obstacle and the fault lies in the fragmentary and intuitive way that it is managed (Colton & Williams, 1997 p289). Relationships with the biological family have, however, been cited by caregivers as one of the major stressors of the care giving task (Barrett, 2002). In New Zealand such relationships are seen as too risky and are usually discouraged, according to anecdotal evidence provided by social workers and non-kin foster parents.

It must be realised, however, that for some children and young people, return home is not able to be considered, owing to the level of family dysfunction or the continuing level of behavioural difficulty. There has also been comment about the dangers of a managed care system that sets definitive periods of intervention, after which the young person must be discharged. Moving young people out of care while they still have behavioural and emotional deficits to suit fiscal policies, can result in many young people being at risk of self-harm, unemployment, substance dependence and criminality (Yates, 2003; Ward, 2000).

One of the enduring concerns noted in the foster care literature over many decades is that of foster care drift and the necessity to establish permanency and placement stability for the well-being of the children. It is a key measure in the evaluation of programme success. Linares & Monalto, (2003) state that foster carers face unique parenting challenges. The need to create a corrective therapeutic experience for the child or young person in the midst of placement uncertainty and potential grief and loss is complicated by the fact that carers are uninformed about how long the child will remain in their home and often, due to a court decision the child’s departure can be sudden. They claim that while in the past foster parents were warned not to get attached to the children in their care, carers now have the task of helping children develop a healthy new attachment to the foster family, while supporting and nurturing the primary attachment to the biological family (Linares & Monalto, 2003).

The need for the child to achieve permanency is a key factor in the 1989 Children Young Persons and their Families Act. One of the difficulties, however, is the conflict between legal time-frame requirements and the child’s need to attach. Barratt (2002), reflecting on foster care practice in Britain, states that foster carers who were told that placement would be for a maximum of six months still have the child with them after two years, growing increasingly attached while permanent placements were found. This situation also occurs in New Zealand. Corrick (1999) makes the point that the presupposition that a child will be able to move to a regular placement when the child is ‘cured’ in a treatment foster care placement, ignores the fact that the child and carer may have formed an attachment which should not be broken and if moved, the child might well regress and again need specialist skills. This, of course, prevents the skilled ‘professional’ carer from taking another child needing specialist care. If the child remains with the carer an issue of payment arises, as the skills of the carer are not now considered essential for this child.

The disproportion of minority children in the State Welfare system is commonly discussed in the literature, and the appended data shows that Maori children are still disproportionately represented in New Zealand care statistics. However, it would appear that there is a relative paucity of literature around particular issues of culture and how this might affect practice models. While the international literature identifies an ethnic imbalance between minority children needing care and availability of culturally matched carers, New Zealand law attempts to overcome this by dictating a hierarchy of placement preference - out of culture care being the last option. However, anecdotal evidence would indicate that there are still many cross – cultural placements occurring, even if they are temporary in nature. As Butcher (2004) claims, there is a need for an indigenisation of all foster care training curricula for both indigenous and non-indigenous carers, with particular emphasis on the distinctions between respective cultural traditions (Butcher, 2004 p48).

Internationally, foster care is moving away from a system in which well meaning people volunteer to take children and young people in, towards systems where carers are highly trained professionals, supported by other highly trained specialists. However, this perception does not carry universal favour and is resisted by both those who see foster care as a loving religious or charitable act, and by administrators who wish to save money. The ‘volunteer’ aspect of foster care has been inherent in the role since its inception and it is demonstrated in the literature that carers are motivated by both altruism and self-interest.

Hutchinson et al. (2003) claim that the specific needs of children who have suffered abuse and/or neglect or who have severe psychological problems will be met only by highly trained and skilful carers, who can provide a therapeutic environment for traumatised children and young people and work with a whole care team of social workers, doctors, educationalists and therapists. They argue that the level of skill and knowledge needed by carers will not be met by standard preparation and training and further, they state that foster care service agencies need to firstly:

·  make a clear assessment of the needs of children in their care, both present and future, and profile the carers needed, in terms of numbers of carers at different skills levels;

·  recognise that the current level of competences needing to be demonstrated for caregiver approval is only a baseline of necessary skills;

·  provide structured mandatory in-service training programmes to enable the building of a highly skilled foster care workforce;

·  obtain evidence of the effectiveness of these in enhancing caregiver skills;

·  match children’s needs with carers skill levels;

·  reward carers financially according to their skills level, not the characteristics of the children placed at any one time.

Hutchison et al (2003) admit that the implementation of these requirements would make heavy demands on both service providers and carers, and that they amount to a fully professionalized foster care service that:

·  rewards carers financially at the level of full-time employment and according to their level of skill

·  pays out for 52 weeks of the year, regardless of whether a child is placed or not

·  matches the skill level with the needs of the child/ren

·  supports carers to make provision for [retirement] pensions

·  offers professional supervision for the foster care family that recognises the impact of caring for traumatised children and assists in developing management strategies

·  affords career development by linking professional development programmes to externally recognised qualifications

·  offers superannuation scheme support

·  offers respite care for foster families

·  gives paid holiday periods

·  provides accessible, appropriate out of hours support

(Hutchinson et al. 2003, p.12).

Corrick (1999) argues that while professionalisation of carers might make social workers uneasy in the short term, it would afford carers a sense of identity and a professional body that could negotiate on their behalf. It would make the relationship between social workers and carers more equal and, ultimately, more beneficial for all, children, carers and social workers. Research shows that treating carers as ‘professionals’ and rewarding them adequately assists in both recruitment and retention and increases the safety and happiness of children in care.

The children who now come into care are those who have suffered serious abuse, neglect or trauma and who consequently have the most serious health, behavioural and relationship difficulties. Research shows that even young children are experiencing multiple placements as carers cannot manage their behaviour or the foster care role. The danger of allegations of abuse being laid against the caregiver is a concern for both caregivers and social workers alike. The New Zealand Family and Foster care Federation evaluation of their Caregiver Allegation Support Project showed that both kin and unrelated caregivers who have allegations laid against them are likely to give up caring, even if the allegations remain unsubstantiated (Worrall, 2005).

Tapsfield & Collier (2005) make the point that while adopting professional models of care, such as Multi-level Treatment Foster Care, will call for considerable financial investment, the additional costs will be off-set in the short term by efficiency savings. More importantly, there will be considerable long-term benefits from a service which offers children and young people in care the same opportunities to have a successful future as all other children in society. It is widely accepted that children who grow up in care are more likely to need mental health services, go to prison, be homeless and have their own children removed from them. The cost of doing nothing to improve outcomes for these children is, in the long term, a far greater one for all concerned.

Table 1. Numbers of Children in care Placements by Care Type and Ethnicity

Fiscal Year / Ethnic Group / Number / Proportion
Non-Kin / Kin / Total / Non-Kin / Kin / Total
at June 2007 / NZ Maori / 1143 / 1234 / 2,377 / 48% / 52% / 100%
NZ Pakeha / 1,512 / 633 / 2,145 / 70% / 30% / 100%
Pacific Islands / 136 / 175 / 311 / 44% / 56% / 100%
European / 12 / 11 / 23 / 52% / 48% / 100%
Others / 81 / 42 / 123 / 66% / 34% / 100%
Not Recorded / 49 / 21 / 70 / 70% / 30% / 100%
Total / 2933 / 2116 / 5,049 / 58% / 42% / 100%
at June 2008 / NZ Maori / 1008 / 1158 / 2,166 / 47% / 53% / 100%
NZ Pakeha / 1,306 / 582 / 1,888 / 69% / 31% / 100%
Pacific Islands / 113 / 165 / 278 / 41% / 59% / 100%
European / 22 / 13 / 35 / 63% / 37% / 100%
Others / 81 / 19 / 100 / 81% / 19% / 100%
Not Recorded / 2 / 1 / 3 / 67% / 33% / 100%
Total / 2532 / 1938 / 4,470 / 57% / 43% / 100%
Worrall (2008)
References

Barratt, S. (2002). Fostering care: the child, the family and the professional system [Electronic version]. Journal of Social Work Practice, 16, (2), 163-173.